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A Look Into Living With PTSD

One of the most frequent comments I hear about “The Shifting Sands” is how it gives an honest look into what it is like to develop Post-Traumatic Stress Disorder and subsequently live with it. I’m not certain about the second part: Mike doesn’t live with his PTSD, he runs from it. Which is a very common reaction to it. But it isn’t “living” with it.

I was thinking about it this morning. While, in general, the public has become more accepting that PTSD exists and can prevent us from engaging in otherwise normal social activities, I still get the idea they don’t quite understand the power it can have over us. I was trying to come up with a way to explain this, and I think the easiest way to do it is to explain anxiety/panic attacks.

At its heart, an anxiety attack is nothing more than the “fight or flight” response kicking in quite unexpectedly. So, first of all, you need to understand what that means. Think back to that time you were nearly in a car accident, or a bar fight, or when you thought you lost your child in the store – your heartbeat doubled or tripled in an instant, you suddenly felt very hot from the increased rush in blood. Your hands were shaking – your eyes jumped from one thing to another with spastic unpredictability. You unconsciously balled your hands into fists and relaxed them, over and over. It felt like a someone was sitting on your chest – your breathing came in shallow, quick, gasps. Your knees itched – right under the kneecaps, where you couldn’t reach it. Your legs wanted to take you somewhere, anywhere, but you didn’t know where to go.

This is a perfectly legitimate response to a threat or fear – it is the “fight of flight” response doing exactly what it is supposed to do.

Now, for some who have experienced traumatic events, their mind has somehow retrained itself to respond with the fight or flight response in situations similar to their original trauma – what people in the mental health community call “trigger events” or just “triggers”. For someone who was raped, for example, a trigger could be a person wearing similar clothing, or the area where it happened, or even the smell of the perfume/cologne the rapist was wearing. Anything that reminds the victim of the assault. The victim has little or no control over what the body does next. The body responds to these triggers in a way as to prevent the same kind of assault from happening again – it is a survival mechanism born of evolution, born of an intelligent species that learned early on to identify threats and eliminate them or flee them, thus making the species the dominant one.

That still seems rather reasonable, of course: a car accident victim will have an anxiety attack in the area where the accident occurred, or when seeing a similar car as to the one that hit them. A rape victim will respond with a panic attack when confronted with something that reminds them of the rape. Someone who witnessed a shooting at a convenience store will get scared at the sight of a gun, or of someone wearing similar clothes as the shooter. That makes sense to anyone: you learned that something is bad and dangerous, and you want to avoid it. Simple.

But this is where the soldier’s body, and anyone who has severe PTSD, goes above and beyond in its effort to survive. Severe PTSD is often associated with repeated and long-term exposure to traumatic events and survival situations. Someone in this group spent enough time in a “do or die” mindset, it has became their default mode.

So the list of triggers for a soldier is much greater than that of others, in many cases. A soldier can be triggered by things he or she can’t even rationalize as a trigger. Basically, the way I see it, we developed the instinct to know when something is “off”. That is part of surviving in a day-to-day combat environment. You get what others would call a “sixth sense” about things not being right. And you listen to that sixth sense – because there is a chance if you don’t, you die.

Now, what does this mean? It means I can be sent into an anxiety attack for things that make no damn sense to others. The most recent example was my preschool daughter’s Thanksgiving recital at her school:

A smallish classroom, with about a dozen students and twice as many parents and grandparents. Nothing threatening about that, right?

Wrong. I didn’t know all the people in the room – instantly, my senses go on heightened alert. But I know this feeling, I have to deal with it every day, so I can control that. For a while, at least. But, then, things get worse. One lady has a tendency to walk behind me – to not block my view, I’m sure, but I can’t stand someone behind me. So I move away from her. Now my fingers on my left hand are twitching and rubbing against each other. That’s one of my first warning signs.

I moved to the opposite side of the room from her, which also happened to be where the door was. I was in a bad way now – I need to see the entrances and exits. I need to know who is coming in and who is leaving and my best way to get out should something go wrong. But, if I watch my daughter sing, I can’t watch the door. So I turn sideways and pretend to read the board while watching both out the corner of my eyes.

I turn back as often as I can so my daughter can see I’m paying attention. During one of those turns, someone comes in late. Behind me. The door opens. I spin around, stare at him for a second, before convincing myself he probably isn’t a threat. I turn back to the show.

After about fifteen minutes, I am shaking. The first break comes along and I make a run for the door – for the outside. It’s cold out there, I can breathe, I can stay away from people. Only for a few minutes, but at least I’m free. I count cadence in my head – the marching songs we use in the Army – because it clears my mind with hypnotic nonsense. I relax a bit. Go back inside.

The same thing plays over and over. Eventually, the recital ends and I can retreat to the car. I’m somewhat secure in the car – not because it is any safer than anything else, but because my body was trained to view the armored beasts we drove in Iraq as safer than standing in the street. I won’t fully relax until I am back home, in my dark office space, hidden from society and those I’m afraid I will hurt if something goes wrong.

I want you to understand this:

Imagine you are out at the local bar talking with your friends. You are having a good time, you’re relaxed. Someone walks in – he’s that guy that just makes you think, “Something isn’t right.” You know that person – the kind that, when he appears in the Walmart aisle with you, you pull your child closer. Normally, you look at him for a second and then return to whatever you were doing. But not this time. This time, for a reason you can’t possibly imagine, your heart starts pounding. Your hands shake. You get hot and it is difficult to breathe. Your friend is still talking, but you can’t hear him over the rush of your own heartbeat in your ears. You still nod along, but you don’t care what he is saying. Now all you want to do is leave – get away, get home, get safe.

You tell the people you are with that you want to go. They are having a great time and don’t want to leave. Maybe you try to hold out for a little longer. But it is only getting worse. People moving behind you make you twitch and turn. You don’t turn to look at them, you don’t spin, you jerk and twitch – as if your body is a puppet on the ends of some sick man’s strings. You are sweating. Eventually, you work up the courage to tell them why you want to leave. Then comes the inevitable, “You’re fine. There’s nothing here threatening you.” As if that makes any difference.

Somehow, with their help or without, you will make it home. You will be as safe as you can be. And they won’t understand. They say they “get it” in the same sentence with, “but you know you were safe, right?”

No. No, you weren’t safe.

Now, imagine that kind of feeling come over you with no warning – after a night where you managed to sleep all of two or three hours. And when you did sleep, your dreams were hellish landscapes of screams and blood and body parts.

Finally, put that all together, and realize that it is every day for some of us. And also realize that when you do see us, you are seeing us at our best. We are medicated, saturated, sedated. It was the one day we got four hours of sleep. We’re feeling better than we have felt in a few weeks – and we’re running at what you would consider “broken”. We only go out then, and only for a short time.